Epidemiology Commons^™

Using A One Health Approach For The Assessment Of Rabies Control In Rural Victoria Falls, Zimbabwe, Ryan Lapenna

Electronic Thesis and Dissertation Repository

Rabies, a viral zoonotic disease, is widespread in Zimbabwe, with human fatalities reported annually in the country. To supplement the Government’s effort on rabies control, the Victoria Falls Wildlife Trust and Veterinarians for Animal Welfare Zimbabwe have joined forces to carry out dog rabies vaccinations in rural communities adjacent to the major tourist attraction of The Victoria Falls. A One Health approach was used to 1) determine the level of protective rabies antibodies among a sample of rural dogs and 2) collect information and describe the knowledge, attitudes, and practices related to rabies among dog owners. In 2020, blood was …

The Quality Of Life Of Patients With Eye Diseases, Brian Edward Yu

Electronic Thesis and Dissertation Repository

Background: Health-related Quality of Life (HRQoL) values determined using direct elicitation methods and generic preference-based measures are important for economic evaluations of healthcare interventions. The ophthalmology clientele is vulnerable to psychological stressors in the context of the coronavirus disease 2019 (COVID-19) pandemic.

Objectives: To systematically identify and summarize the quality of life (QoL) of eye disease patients in general in North America and seniors with eye diseases during the COVID-19 pandemic.

Methods: A systematic review identified North American studies that quantified HRQoL of eye disease patients. A cross-sectional study was conducted among seniors with eye diseases and backwards stepwise regression …

Incidence Of Cancer And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders, Jared C. Wootten

Electronic Thesis and Dissertation Repository

Evidence on cancer incidence in people with psychotic disorders, compared to the general population, is equivocal, although those with psychotic disorders so have more advanced stage of cancer at the time of diagnosis. The objective of this thesis was to compare cancer incidence and stage at diagnosis for people with psychotic disorders, relative to the general population. Our systematic review did not observe a significant difference in overall cancer incidence among people diagnosed with psychotic disorders (RR = 1.08, 95% CI: 1.00 to 1.16), however people with psychotic disorders were more likely to be present with advanced stage cancer at …

Epilepsy Risk Among Survivors Of Intensive Care Unit Hospitalization For Sepsis, Tresah C. Antaya, Britney N. Allen, Lucie Richard, Salimah Z. Shariff, Gustavo Saposnik, Jorge Burneo

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• 407 (0.28%) patients developed epilepsy within 2 years of their ICU discharge, 103 (25.3%) of whom were exposed to sepsis.
• Sepsis survivors were significantly more likely to develop epilepsy, relative to non-septic ICU survivors.
• Among sepsis survivors, epilepsy risk increased with age and was higher among those with chronic kidney disease.

Hiv-1 Group M Subtype Fitness, Disease Progression, And Entry Efficiency, Colin M. Venner

Electronic Thesis and Dissertation Repository

Human immunodeficiency virus type 1 (HIV-1) emerged in the human population shortly after the turn of the 19th century. Distribution of HIV-1 across the globe over the past 30–35 years can be traced to founder events with primordial HIV strains from sub-Saharan Africa. Even considering the burden of HIV in Africa, our knowledge of HIV-1 disease is still largely limited to subtype B HIV-1, a strain responsible for 3 million infections in North America and Europe as compared to the 33 million that are infected with HIV-1 subtypes A, C, D, and circulating and unique recombinant forms.

This dissertation analyzes …

The Risk Of New-Onset Epilepsy And Refractory Epilepsy In Older Adult Stroke Survivors, Jorge G. Burneo, Tresah C. Antaya, Britney N. Allen, Andrea Belisle, Salimah Z. Shariff, Gustavo Saposnik

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• Stroke is a common cause of epilepsy in older adults, but little is known about stroke-related epilepsy or its outcomes in this population.
• 1.1% of older adult stroke survivors developed epilepsy in this study, of whom 12.9% developed refractory epilepsy, indicating that this population is particularly responsive to treatment.
• Over 85% of deaths in this population are not due to stroke or epilepsy.

Risk Factors For Bk Virus Infection After Kidney Transplantation, London, Ontario 2016, Seyed M Hosseini-Moghaddam

Electronic Thesis and Dissertation Repository

Our objective was to determine the risk factors for BK virus infection in renal allograft recipients in the first year after transplantation. In this cohort, we included all patients who received renal allograft at London Health Sciences Centre (LHSC) between 2012 and 2014. We continued post-transplantation follow-up for one year. Of 175 patients (37% female) with median age (range) of 53 (14-82) years, 40 (22.9%) developed BK viremia (median interval:100 days, range: 35-264). Recipient age, recipient gender, hemodialysis (HD) vs peritoneal dialysis (PD), Human Leukocyte Antigens A1, B35 and Cw4 increased the risk of post-transplant BKV infection. However, donor gender, …

Development Of Clinical Prediction Models For Surgery And Complications In Crohn’S Disease, Leonard M. Guizzetti

Electronic Thesis and Dissertation Repository

Background and Objective: Crohn’s disease (CD)-related complications account for a substantial proportion of IBD-related healthcare expenditure. Identifying patients at risk for complications may allow for targeted use of early therapeutic interventions to alter this natural course. The objective of this project was to develop risk prediction models of CD-related surgery and complications.

Methods: Using data from the REACT cluster-randomized clinical trial (N=1898 from 41 community practices), prediction models were developed and internally validated for CD-related surgery and CD-related complications, defined as the first CD-related surgery, hospitalization or complication within 24 months. Performance of each model was assessed in terms of …

Cost-Effectiveness Of Selective Laser Trabeculoplasty (Slt) Versus Argon Laser Trabeculoplasty (Alt) In Uncontrolled Open Angle Glaucoma Patients Having At Least One Full Previous Slt: An Economic Evaluation Alongside An Ongoing Randomized Controlled Clinical Trial, Muhammad Rakibuz-Zaman

Electronic Thesis and Dissertation Repository

Background and objective: ALT and SLT are both safe and effective for glaucoma treatment. We performed a cost-effectiveness analysis (CEA) of SLT versus ALT for a six-month follow-up period in uncontrolled open angle glaucoma patients having at least one full previous SLT from an ongoing RCT. Methods: Trial based treatment costing and IOP reduction at 6-month follow-up from baseline for both intervention arms were calculated. A decision tree model was developed considering possible clinical pathways of patients undergoing repeat laser trabeculoplasty. CEA among ALT and SLT was done, and ICERs were calculated from both societal and ministry perspective. One way …

A Link Between Paediatric Asthma And Obesity: Are They Caused By The Same Environmental Conditions?, Phylicia Gonsalves

Electronic Thesis and Dissertation Repository

The highly associated paediatric conditions of asthma and overweight have seen dramatic increases over the past few decades. This thesis explored air pollution exposure as a potential underlying mechanism of co-morbid asthma and overweight among adolescents aged 12 to 18 years. Data from the Canadian Community Health Survey were merged with a database containing estimates of air pollution as assessed by particulate matter ≤ 2.5 microns (PM_2.5) concentrations at the postal code centroid in southwestern Ontario. Logistic regression was used to conduct the analysis. Adolescents were more likely to be overweight as PM_2.5 concentrations increased. There was …

Evidence For Using Immunosuppressive Treatments When Treating Idiopathic Non-Infectious Uveitis: A Systematic Review And Meta-Analysis, Hargurinder Singh

Electronic Thesis and Dissertation Repository

Idiopathic non-infectious uveitis is the spontaneous inflammation of the eye, which can lead to blindness if not treated correctly. Due to long-term side effects of corticosteroids, 4 classes of off-label immunosuppressive treatments are sometimes used (alkylating agents, inhibitors of T-lymphocyte signalling, antimetabolites and biological modifiers). We conducted a systematic review and meta-analysis to assess the effectiveness of different treatment classes on uveitis patients with similar characteristics. Results of the systematic review concurred with the conclusions from the meta-analysis, which found that all immunosuppressive treatments improved patient vision, with a statistically significant change in logMAR of -0.11 (95% CI of -0.152 …

Survival Outcomes And Treatment Utilization Among Patients With Known And Unknown Primary Tumours In Ontario., Chong Sung Kim

Electronic Thesis and Dissertation Repository

I identify two cohorts of cancer patients with known and unknown primary tumours. Cancer of unknown primary (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Using the Ontario Cancer Registry, Same Day Surgery/Discharge Abstract Database and Ontario Health Insurance Plan, a novel linkage strategy was developed to cross-validate diagnoses. I found CUP patients represent a significant portion of all metastatic cancers. CUP patients with histological confirmed disease, squamous cell histology, or metastases localized to nodal regions had significantly better survival than other CUP patients. Knowledge of the primary …

Overall Survival And Biochemical Failure-Free Survival Comparison Of Brachytherapy Treatment Options Versus External Beam Radiation Therapy For Both Low And Intermediate-Risk Prostate Cancer: A Propensity-Score Matched Analysis, Graham D. Smith

Electronic Thesis and Dissertation Repository

Purpose: This study compares overall survival (OS) and biochemical failure-free survival (bFFS) in low- and intermediate-risk prostate cancer patients that received brachytherapy [low-dose-rate brachytherapy (LDR-BT) or high-dose-rate brachytherapy with external beam radiation therapy (HDR-BT+EBRT)] versus external beam radiation therapy (EBRT) alone.

Materials/Methods: Patient data was obtained from the ProCaRS database, which contains 7974 prostate cancer patients treated at four Canadian institutions. Propensity score (PS) matching was used to generate matched cohorts with balanced baseline prognostic factors.

Results/Conclusions: Final PS matches included two 1:1 intermediate-risk patient matches, LDR-BT vs. EBRT (total n = 254) and HDR-BT+EBRT vs. EBRT (total n=388), and …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

Electronic Thesis and Dissertation Repository

Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …